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rib resection part of surgical approach


Tampa, FL
Best answers
hi all,

Frequently the surgeon will resect the rib "so as to allow for easier visualization of the pleural cavity, so as to minimize skin incision, and so as to minimize the chance of iatrogenic injury to cephalad and caudad ribs with rib spreading."

He has been coding 21600 for this however I'm not sure that this should be reported in addition to the surgeries he's performing.

The CCI edits have as one of the examples of services integral to a large number of procedures "surgical approach including identification of anatomical landmarks, incision, evaluation of the surgical field, debridement of traumatized tissue, lysis of adhesions, and isolation of structures limiting access to the surgical field such as bone, blood vessels, nerve, and muscles including stimulation for identification and monitoring."

Would the rib resection be included in the above? Is anyone billing this separate?

Thanks for the help,

Shena Betts, CPC


Best answers
rib resection

Shena, I tend to agree with you on not billing for 21600. The only time i usually bill for a rib resection is when I use 32035 for am empyema. Given the rule you've posted it would appear that his intent is not to go in for an actual rib resection. This is usually the only time I would code for it. I'm certainly no expert but I would go with you on this one and not bill for it.

Nicole, CPC